| Objectives 1 To compare the safety and efficacy of direct aspiration thrombectomy and sent thrombectomy in the treatment of large artery atherosclerosis(LAA)type acute ischemic stroke(AIS)and evaluate the therapeutic effect of direct aspiration thrombectomy.2 The efficacy and safety of direct aspiration thrombectomy in the treatment of AIS in different subtypes of AIS were compared,so as to find the best neurological interventional treatment for patients with different etiology of AIS.Methods 1 A total of 103 patients with LAA type AIS who underwent mechanical thrombectomy in our hospital from January 2018 to October 2019 were selected,of whom 43 were treated with direct aspiration thrombectomy(aspiration group)and 60 were treated with stent thrombectomy(stent group).Successful recanalization was assessed by modified treatment in cerebral infarction(m TICI),and the clinical outcomes of patients were assessed by the National Institute of Health Stroke Scale(NIHSS)score and the modified Rankin Scale(m RS).The safety of treatment was evaluated by operative complications such as embolus to new territory and intracranial hemorrhage.The successful recanalization,clinical function prognosis and safety of the two groups were were further compared and analyzed.2 To retrospectively analyze 54 patients with AIS treated with direct aspiration thrombectomy in our hospital from April to October 2019.According to the Trial of Org 10172 in the Acute Stroke Treatment(TOAST),it was divided into 40 cases in LAA group and 14 cases in CE group.Successful recanalization was assessed by m TICI,and the clinical prognosis of patients was assessed by NIHSS score and m RS score.Safety was assessed by operative complications such as embolus to new territory and intracranial hemorrhage.To compare successful recanalization rate,the rate of angioplasty and stenting,good functional outcome rate at 90 days and the safety between the two groups.Results 1 1)The time from puncture to successful recanalization was [35(19,54)min vs.35(30,53)min,P=0.468] between the aspiration group and the stent group.Although the successful recanalization rate [90.7%(39/43)vs.83.3%(50/60),P=0.282] in the aspiration group was superior to that in the stent group,the difference was not statistically significant.2)NIHSS scores of the aspiration group and the stent group were respectively [10(5,14)vs.10(6,15),P=0.954,8(3,12)vs.18(2,15),P=0.744],and the good functional outcome rate of the 90 d was [48.8%(21/43)vs.46.7%(28/60),P=0.828],the difference was not statistically significant.3)The aspiration group and the stent group with embolus to new territory[4.7%(2/43)vs.3.3%(2/60),P=0.733]and intracranial hemorrhage rate[9.3%(4/43)vs.13.3%(8/60),P=0.529],there was no statistically significant difference.2 1)The time puncture to successful recanalization [36(24,57)vs.28(17,36)] was longer than that of the CE group.The rate of angioplasty and stenting in the LAA group was higher than that in the CE group(P<0.05).There was no significant difference between the LAA group and the CE group of reperfusion at first pass rate and the rate of successful recanalization(P>0.05).2)Compared with the CE group,NIHSS and the clinical outcome rate of good function at 90 days of the LAA group showed no statistical difference(P>0.05).3)There was no statistically significant difference in the rate of embolus to new territory and s ICH between the LAA group and the CE group(P>0.05).Conclusions 1 The efficacy and safety of direct aspiration thrombectomy in the treatment of LAA type AIS patients are comparable to that of stent thrombectomy,which is an effective treatment method for LAA type AIS patients.2 Direct aspiration thrombectomy is also safe and effective in the treatment of LAA and CE type AIS patients.Compared with patients with LAA type AIS,patients with CE type AIS are more suitable for the treatment of direct aspiration thrombectomy.Table10,Reference 162... |
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